Vision for Public Health within a Liberal Arts College Education

A Vision for Public Health within a Liberal Arts College Education
By Richard Allan Aronson, MD, MPH

Public health embraces and inter-connects the humanities, the social sciences, and the natural sciences. It is both a science and an art. Its study offers a wide and rich array of opportunities for students to: 1. Think critically. 2. Learn scientific methods of inquiry. 3. Synthesize across disciplines. 4. Understand complex and interconnected factors that underlie health problems. 5. Apply culture and language to health, healing, and disease. 6. Appreciate and learn to translate a body of knowledge into action to improve the health of communities and society.

It is deeply rooted in prevention but, at the same time, seeks to create communities and society that care about people’s health across the life cycle. It embraces language, and it embraces culture. It seeks healing in the deepest sense - healing that is rooted in physical, emotional, spiritual, and environmental balance, well-being, and safety. Whether you are a community health worker, a public health nurse, a teacher, a physician, a social worker, a psychologist, an occupational therapist, a physician’s assistant, a champion for women’s health, an anthropologist, a business person engaged in economic development, a global health expert, an early childhood specialist, a researcher on how and why toxic stress and trauma have lifelong and intergenerational consequences, an expert on resilience, a nutritionist, a leader in public policy, a community leader and activist, or so many other paths, public health provides multiple opportunities:

1. To apply the idealism of a liberal arts education to action on issues that students are passionate and curious about.
2. To view health and healing in the broadest possible context.
3. To create new and expanding partnerships rooted in synergy, synchronicity, serendipity, fluidity, and the art and social science of collaboration across cultures.
4. To celebrate diversity.
5. To discover new and higher levels of common ground and shared humanity that provide a foundation for real, effective, systemic change.
6. To foster humane conditions that bring out the best in people – hope, resilience, spirit, dignity, healing, compassion.

Through the public health mission of bringing together people from different backgrounds, cultures, and perspectives to address public health issues; through opportunities to join in efforts to give a voice to those who have been marginalized and oppressed; and through the classroom energy generated by the study of public health in the liberal arts setting, we can envision a world where every child has the full equal opportunity to thrive in mind, body, and spirit.

And in the community-based learning that is integral to the study of public health, students from early on have the opportunity:

1. To learn to listen more inclusively and humbly to those with whom we work.
2. To learn to honor the people that we serve, especially those whose voices have been stifled and excluded.
3. To learn to put into practice the reality that expertise is not defined by the titles or degrees after your name, but by the unique gifts and skills that you bring to bear to make the world better.

Upon receiving an Amherst College honorary degree in New York City in 2005, Nelson Mandela said, “I come from a country that understands the need for hard work to overcome past destructiveness and to escape a threatened future. But, we have also learned that miracles happen with vision and spirit. The world needs that vision and spirit still, and all the more. We are all threatened by entrenched inequality and divisions. We all must prove ourselves equal to a better possibility. “The power of public health lies in rising to this challenge: To be curious about, to understand, and to change that inequality, and in the process, to partner with multiple, diverse people from all walks of life.

It comes down to continuously exploring, discovering, and acting upon the human spirit in all its promise, resilience, and hope, and to bring light into ourselves, our communities, and our world. Human beings can live for roughly 8 to 12 weeks without food, 8 to 12 days without food and water, 6 to 8 minutes without oxygen. But without the spirit, a certain kind of death is inevitable in just a few seconds. And so it is that an inscription found on a cellar wall in Germany written by a Jew in hiding from the Nazis contained these words: “I believe in the sun even when it is not shining, I believe in love even when there is no one there, I believe through any trail there is always a way. And I believe in God when God is silent.”

Proposal for a Two-Semester Undergraduate Course on Public Health Disparities and the Community

The potential for a liberal arts education to inform and inspire a new generation of public health leaders is extraordinary. Tapping into a surge of interest in public health on college campuses, Richard Aronson, MD, MPH, is exploring innovative strategies to teach, mentor, and facilitate learning that is rooted in knowledge and experience in the social determinants of health, health equity, and the life course perspective. Through his current position as Assistant Adjunct Professor of Public Health at Hampshire College, he hopes to make this liberal arts approach to public health and health inequality come alive. The Five College Culture, Health, and Science Program and the new Amherst College Public Health Collaborative are two great resources for this work, as well as the Amherst Center for Community Engagement and its counterparts in the Five College community. In this way, the Humane Worlds Center for Maternal and Child Health could find its home. Dr. Aronson welcomes comments on the following draft proposal for a two-semester undergraduate course that would form the core for such a program:

Public health faces challenges that require multi-faceted inter-disciplinary approaches that are rooted in community based learning. Such learning addresses root causes of health disparities and the complex process of respecting the language and culture of diverse communities. The purpose of such learning, which lies at the heart of a liberal arts education, is to equip students with knowledge, critical thinking, and experience to create a more humane and just world. To achieve this purpose, students need to understand, in theory and practice, how broad and equal participation of many stakeholders and collaboration is central to the mission of public health.

We propose a two-semester course at Hampshire College, with vibrant Five-College and Culture, Health, and Science Program participation, which integrates the knowledge of public health disparities with community-based learning and practice. The course will draw on research that shows 1) How various forms of inequality, injustice, and stress influence health and create unconscionable health inequalities, 2) How resilience and other positive resources in people, families, communities, and systems provide the potential to create health equity, and 3) How inclusive dialogue, collaborative action, and cultural and linguistic competence form the foundation for inclusive, community-rooted leadership. The course provides opportunities for inter-generational and multi-disciplinary dialogue, both in the classroom and in the community, to learn and experience such leadership.

First Semester: A series of seminars, lectures, papers, group work, and presentations in the first semester sets the foundation for the second semester of community engagement. These conversations, rooted in discovery of inter-disciplinary topics and approaches to health disparities, seek to move students to listen inclusively and respectfully to diverse stakeholders; to learn to honor the people whom we serve, especially those whose voices have been stifled and excluded; and to learn to theories for how to put into practice the reality that expertise is not defined by the titles or degrees after one’s name, but by the unique gifts and skills that people bring to bear to make the world better.

Second Semester: The second semester would have a smaller class size of about ten. It provides the student with an opportunity to engage with community partners in a project that is of mutual benefit to the student and the community. It provides students with 1. Experience in inter-disciplinary and collaborative group work that is central to public health, and that makes public health exciting and fruitful. 2. An opportunity to synthesize classroom knowledge and personal experience to explore in depth a specific public health disparity in a local community/ 3. A chance to explore ways that active involvement to address a public health issue can have an impact on health disparities; and begin to develop personal long-term strategies for creating social change for health.

Prerequisites: Students who take the course should demonstrate potential to be curious about, to understand, and to want to actively improve the health of communities; and to partner with multiple, diverse people from all walks of life.

Principles: Some of the underlying principles of the course are the following:

1. Involvement of community partners in a variety of forms is integral to all aspects of the course, at every stage.
2. The commitment of the course faculty is long-term. It extends beyond one academic year to a series of actions and activities, such as summer internships and annual orientations, to ensure continuity of the commitment to a sustained partnership between the school(s) and the local communities.
3. While one faculty member would run the course as a whole and assume chief responsibility for mentoring and teaching, drawing upon and involving other faculty, such as CHS, from the Five Colleges is an important part of the overall approach to the course.
4. Ongoing evaluation and learning lessons are used to refine, revise, and strengthen the course and the partnerships that develop.

This course seeks to offer a small-scale model for the application of community-based learning within the context of liberal arts education in public health. It seeks to unite students with community stakeholders and serve as a catalyst for essential but previously unlikely partnerships. Its ultimate purpose is to harness the ideals of a liberal arts education to the challenge of enabling people to discover common ground for new action to improve the conditions that influence the health of people and populations and reduce the inequities among them. Such action can lay the foundation for leadership needed to bring dignity, hope, and equity to people. We seek to move away from systems that thrive on pathology, medical diagnosis, and risk reduction. Instead, we envision systems and policies that derive their power from resilience, trust, respect of culture and language, and community. Our species has a remarkable capacity for healing and cooperating for the common good. The purpose of the course is to mobilize that capacity. The course will be a learning greenhouse to support educational methods that engage communities and inspire students to practice effective forms of social action. In so doing, the course can contribute to bringing up a new generation of leaders with lifelong tools to actualize their ideals.

Examples of course content:
1. Teaching, mentoring, advising, dialogue, organizing, advocating, and experience to learn and practice public health in the community.
2. Synthesizing research on social determinants of health, resilience, traumatic childhood experiences, racism, chronic stress, language, and conditions for productive dialogue that will have a significant impact on future public health practice.
3. Translating this research into humane public health practice to improve the health of women and children and families, with systems that honor families, communities, and cultures.
4. Integrating cultural understanding and respect as a key strategy to end health disparities.
5. Changing the language of public health and medicine to better reflect our ideals and purpose.
6. Bringing multiple stakeholders together to untangle complex public health challenges and take collaborative action to solve them.

Health Disparities Course Syllabus

Here is the syllabus, except for individual class assignments, for the course on Health Disparities (Natural Science 209) that Dr. Richard Aronson, MD, MPH, taught at Hampshire College in the fall of 2009:

Social injustice and inequality create conditions that lead to unconscionable health disparities according to race, ethnicity, childhood experiences, gender, income, nationality, and many other factors. How can it be, for example, that while infant mortality in the United States has declined during the past century, the rate at which black babies die is at more than twice the rate of whites? How can it be that roughly 500,000 women in the world die each year of largely preventable causes related to pregnancy and birth? How can it be that in the same city, the average life expectancy for people living in one neighborhood is 10 years less than for those living in another neighborhood just a few miles apart?

This course explores the multi-faceted origins of selected health disparities. It highlights the real potential, vital importance, and urgent need for solutions: health policies, systems, and programs that are humane, culturally respectful, and effective. How do we define health disparities in a public health context? How do such disparities occur and persist across generations? What is the "life course perspective" for maternal and child health? Specifically, how does chronic stress experienced by women of color in the U.S. make them more likely to give birth to premature and low weight babies? And how are traumatic childhood experiences associated with earlier and more severe chronic diseases in adulthood? We will explore research related to these questions, and then consider specific promising disparity-based practices in the U.S.

We critically examine how such practices tend to: 1) Draw on the resilience of individuals, families, and communities; 2) Tap into the potential for social capital to enrich physical, mental, and spiritual health; 3) Foster collaborative action among multiple stakeholders, including the communities directly affected, to trust each other and unite as equal partners; and 4) Emphasize learning how culture and language influence health, and how the need to respect culture and to communicate clearly is essential to effective and humane programs, policies, and systems. Throughout the course, we focus on bringing the voices of people who have experienced disparities into our dialogue. The professor is a public health pediatrician with 30 years of hands-on practical leadership experience in. The course will continuously examine how to translate theory into practice.

Purpose: To inform and inspire students interested in public health from a social justice context to engage in learning and creating conditions under which all people have the full equal opportunity to thrive in body, mind, and spirit.
Background: Public health faces local and global challenges that require a multi-faceted inter-disciplinary approach that addresses underlying root causes of social injustice in order to create a more humane and equitable world for all people. To make progress, we need broad inclusive participation of many stakeholders, which requires new forms of leadership. This course provides students with a foundation to learn and practice such leadership. We draw on research that shows 1) How various forms of inequality, injustice, chronic stress, and trauma influence health and create unconscionable public health disparities, 2) How resilience and other positive resources, such as the use of clear humane language, provide the potential to create health equity, and 3) How inclusive dialogue, collaborative action, and cultural and linguistic competence form the foundation for the new leadership. Through class lectures and dialogue, individual meetings, four papers, an oral presentation, a variety of readings and DVDs, and community engagement, students explore the translation of this research into humane practice and public policy. Opportunities are available for students who seek to learn and practice such leadership. Also, the professor is available to mentor those who have or are exploring a passion for public health and public service as a profession, and support them with tools to express their idealism in action. Our model of choice for this work is Future Search (www.futuresearch.net ), a unique planning process that has been used with success worldwide for 25 years to stimulate action on complex social issues.

This course seeks to equip students with information and tools to unite stakeholders and serve as a catalyst for essential but previously unlikely partnerships. Our intention is to enable people to discover common ground for action that they did not realize they shared. Such discovery can lay the foundation for leadership needed to bring dignity, hope, and equity to women, children, and families. The focus of the course is to move away from systems that primarily thrive on pathology, medical diagnosis, and risk reduction. Instead, we envision systems and policies that derive their power from resilience, trust, respect of culture and language, and community. Our species has a remarkable capacity for healing and cooperating for the common good. The purpose of the course, in its small way, is to mobilize that capacity among interested students. The larger goal here is to equip a new generation of leaders with lifelong tools to actualize their ideals.

Course Objectives
1. To understand public health disparities within a social justice framework.
2. To understand the multi-faceted and deeply rooted origins of health disparities.
3. To explore how chronic stress contributes to health disparities.
4. To examine the impact of adverse and traumatic childhood experiences on adult health.
5. To examine public health policy and practice to address health disparities.
6. To understand how policy and practices rooted in resilience, cultural and linguistic competence, and collaborative action can create health equity locally and globally.
7. To acquire practical experience in applying these ideas in communities.


Classes


Part I Introduction and Overview (Week 1)

What is public health, and how does the challenge of addressing health disparities central to public health?
What is maternal and child health?
What is a health disparity?
What is health equity?
What are the major factors that contribute to health disparities?


Part II Public Health and Social Justice (Week 1)

How are social justice and public health inter-connected?

Part III Health Disparities: Origins, models, examples (Weeks 2-6)

New research and increased focus on earlier research in the natural and social sciences are giving us a deeper knowledge of the conditions that give rise to health disparities. This section of the course introduces and explores some of the areas of such research:

A. Stress, Biology, and the Life Course Perspective: The rationale for the life course perspective lies in the concept of allostasis, which refers to the body’s ability to maintain stability through change. According to this model, in the face of chronic stress, including that of racism starting in childhood, the body loses its natural ability for self-regulation. The biological pathways (hypothalamus-pituitary-adrenal axis) that enable the body to reset itself and maintain allostasis in response to stress become accelerated. This acceleration may shut down the endocrine feedback system that enables cortisol levels to return to normal after successful adaptation to a stressful event. Chronically high levels of cortisol suppress immune function, making women, for example, more vulnerable to a series of events during pregnancy that are precursors to preterm birth and low birth weight. Further, the continued and often exacerbated stresses that occur during pregnancy itself may program the fetus in a similar way, setting up a compromised ability to self-regulate throughout the life span. The inequitable distribution of conditions and resources in which people can be healthy, such as education, housing, and economic well being, are multiplied by the effects of discrimination. Among the take-home lessons from the life course perspective is the concept that high quality health and medical care and healthy individual behaviors are necessary but not sufficient to reduce health disparities.


B. Racism: The interaction of stress and biology has been researched and studied, and it is particularly important to consider the role of racism as a stressor. However, the historical misuse of biology, medicine genetics, and social sciences has unfairly pathologized communities of color. It has led to a false dichotomization that fails to take into account the full strengths and capacity of such communities to survive, heal, and thrive. Racism can be conceived of as occurring at different levels. Personally-mediated racism is defined as prejudice or discrimination rooted in often unconscious stereotypes of different groups of people. For example, studies demonstrate how health care providers apply differential assumptions or attitudes about others according to their race. As a result, a woman may experience feelings of being dismissed, not listened to, and not treated with respect, which may have an impact on her decision to present for care in the future. The health care system may support such biases, whether unconsciously and unintentionally, through policies and other institutional practices. Researchers have concluded that environment, not genetics, is the primary factor in what has become unequivocal, i.e. that race has an independent association with LBW and infant mortality.

C. The Adverse Child Experiences (ACE) Study: Conducted from a database of 17,337 adult enrollees in the Kaiser Permanente Health Plan in California, began to publish its research in 1998. Stated simply, it uses a retrospective design that shows a strong association between 10 adverse childhood experiences (ACEs) and major risk factors for chronic diseases, both physical and emotional, in adulthood. The 10 ACEs include several categories of child abuse and neglect, and home environmental conditions related to substance abuse, untreated mental illness such as maternal depression, exposure to violence, incarceration, and loss of one parent. The researchers found that ACEs are widely prevalent and transcend social, economic and racial and ethnic boundaries. Further, a recent paper, “The Enduring Effects of Abuse and Related Adverse Experiences in Childhood”, reviews data to support the concept that the mechanisms for biological impairment in brain and endocrine function among children with multiple ACES are comparable to the mechanisms from the life course perspective studies.

D. Social Capital: A growing body of research on the concept of social capital and connectedness shows that the extent to which we feel meaningfully connected to each other and to our communities is a powerful determinant of health status. Social capital encourages formal and informal social support networks, civic engagement, and a heightened sense of community. It refers to the processes between people that establish networks, norms, and social trust, and facilitate coordination and cooperation for mutual benefit. Such connections enrich our physical and emotional health, and provide a deep well of protection from stresses and adversity. These connections have been shown through numerous studies to strengthen the immune system. A study by Haggerty more than 40 years ago showed that among a group of children harboring the Streptococcal bacillus in their throats, those living in more stressful households were more likely to become symptomatic. Ron David, a member of the Joint Center Health Policy Institute’s National Commission on Infant mortality, has further elaborated on this concept of social connectedness by hypothesizing that “relationships are primary; all else is derivative.”

E. Resilience: Resilience refers to the ability to bounce back from adverse experiences and to avoid their long-term negative effects; the power of people to recover, heal, grow, and succeed in the midst of stress, often overwhelming in nature. Studies of concentration camp survivors, of people with special health needs, and of children in violent unsafe environments demonstrate the potential for human beings to bounce back from severe hardship and stress. For example, it has been shown that resilient children and youth are highly flexible and adaptive and skillful as planners and problem solvers . They also tend to possess an internal sense of power and purpose, and have an engaging social temperament. Resilient families support individual children through the presence of an enduring and loving relationship with at least one adult; hold high and clear expectations for the child and confidence that she can do it; and encourage and expect children to feel that they are valued participants. Schools that promote resilience have a wide array of resources to affirm the unique learning style and strength of students; tap into their imagination and creativity; involve students in real life experience; strengthen their decision-making skills; and provide teachers who affirm and inspire that spark in a student and tell her again and again, “You can do this”. Resilience promoting communities are rich in social support networks and have active and vibrant associations and organizations. A resilience promoting community has a clear vision for its children and youth and is equipped with the resources essential to support healthy growth and development – health care, child care, parent education, home visitation, family resource centers, job training, employment, and housing.

F. Conditions for Productive Dialogue and Action: Research in the social sciences has resulted in leadership and planning tools that are more likely to bring out the cooperative and collaborative action that is essential to eliminating birth outcome disparities. For example, synthesizing 80 years of social sciences research, Weisbord and Janoff identified four principles that foster the high level of collaboration needed for systems change on complex and tenacious problems such as birth outcome disparities, and especially in communities where racial and other tensions are high. The four principles are: 1) Get the “whole system” in the room—those with authority, resources, expertise, information, and need—all in the same conversation. 2) Explore the whole before seeking to fix any part; 3) Put common ground and future action front and center; and 4) Set up meetings so people can do the work for themselves. These broad principles may help in thinking through further the potential methods by which joint action in Wisconsin can be encouraged effectively, with the obvious caution that this is easily recognized as a need and not so easily enacted in practice for many reasons.

Part IV Principles for Creating Health Equity (Weeks 7-10)

As the foundation for public policy to reduce health disparities, it is important to explore some underlying characteristics that have shown promise in successful efforts to create equity. We will examine the following set of assumptions and practices and consider how they can be incorporated into the various dimensions of work to reduce disparities, whether it is related to policies, systems, programs, and services; research; and teaching:
 Honor and respect the dignity of all people involved, and of their cultures
 Consider that everyone is an "expert" and honor all voices, especially those who have historically not been included in the design of the policies that affect them
 Include families and communities as equal partners from start to finish
 Use simple and clear, non-jargon, and non-bureaucratic language and communication
 Draw on resilience, strengths, and resources of all people involved (.
 Collect, follow, analyze, and use data in an honest, clear, and accurate way that is faithful to the core functions of public health and that serves as the foundation for action
 Build and sustain public and political will for action.
 Stay faithful to the purpose of public health, which is not only to end disparities but also to create equity for all people, regardless of race, ethnicity, income, gender, sexual orientation, physical, emotional, and cognitive ability religion, and nationality
 Be non-judgmental, and realize that behind every statistic, every risk factor, every death is a real human being, with all the complexity, magnificence, and potential for good that is in each of us.



Part V Student Presentations, Group Projects, and Discussions

Resource Materials

Readings will include a variety of journal articles, and selected excerpts from the following books.



Weisbord M, Janoff S. Future Search: An Action Guide to Finding Common Ground in Organizations and Communities. Berrett-Koehler Publishers: San Francisco, 2000.

Weisbord Marvin. Productive Workplaces Revisited: Dignity, Meaning, and Community in the 21st century. Berrett Koehler Publishers: San Francisco, 2004.

Weisbord M and Janoff S. Don’t Just Do Something, Stand There: Ten Principles for Leading Meetings that Matter. Berrett Koehler: San Francisco, 2007.

Berkman, Lisa.F. and Kawachi Ichiro. (eds). Social Epidemiology, New York: Oxford University Press, 2000.

Unnatural Causes: Is Inequality Making Us Sick: A four-hour documentary exploring racial and socioeconomic inequities in health. California Newsreel, 2008. (DVD)

Garinger-Monsen Maren, and Haslett, Julia. Worlds Apart: A Four-Part Series on Cross-Cultural Healthcare. Boston: Fanlight Productions, 2003 (DVD)
Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care Institute of Medicine. National Academies Press, 2003.
Handbook of resilience in children Sam Goldstein and Robert B Brooks (eds) . New York: Kluwer Academic/Plenum, 2005.
GGarbarino James: Children and the Dark Side of Human Experience. Springer-Verlag: New York, 2008.

LeLevy Barry S. and Sidel Victor W. (eds) Social Injustice and Public Health New York: Oxford University Press, Inc. Paperback Edition, 2009.

From Neurons to Neighborhoods:: The Science of Early Childhood Development. Institute of Medicine: National Academies Press, 2000.
Block Peter. Community: The Structure of Belonging. Berrett Kohler: San Francisco, 2008.
Lu MC, Halfon N. Racial and ethnic disparities in birth outcomes: a life-course perspective Matern Child Health J. 2003 Mar;7(1):13-30.
Kotelchuck M. Building on a life-course perspective in maternal and child health. Matern Child Health J. 2003 Mar;7(1):5-11.
Geronimus AT. Black/white differences in the relationship of maternal age to birthweight: a population-based test of the weathering hypothesis. Soc Sci Med 1996;42:589-97.
Lu MC, Kotelchuck M, Hogan V, Jones L, Jones C, Halfon N. Closing the Black-White gap in birth outcomes: A life-course approach. Accepted for publication in Ethnicity and Disease 2009.
Lu MC, Kotelchuck M, Culhane JF, Hobel CJ, Klerman LV, Thorp JM Jr. Preconception Care Between Pregnancies: The Content of Internatal Care. Matern Child Health J. 2006 Sep;10(Supplement 7):107-122.

Halfon N, DuPlessis H, Inkelas M. Transforming the U.S. child health system. Health Aff (Millwood). 2007 Mar-Apr;26(2):315-30.

Raphael D (2002). Social Justice is Good for Our Hearts: Why Societal Factors – Not Lifestyles – are Major Causes of Heart Disease in Canada and Elsewhere. Toronto: CSJ Foundation for Research and Education. Available free via www.socialjustice.org.
World Health Organization (WHO), Commission on Social Determinants of Health (2008). Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health. On line at WHO Web Site.
Kristenson M et al. (2004). Psychobiological Mechanisms of Socioeconomic Differences in Health. Social Science & Medicine. 58: 1511-1522.

Syme SL. (2005). Historical Perspective: The social determinants of disease – some roots of the movement. Epidemiologic Perspectives & Innovations. 2:2

Beauchamp DE. Public Health as Social Justice. (RH) Chapter 10. 267-284.

Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP & Marks JS. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The ACE Study. American Journal Preventive Medicine. 14:4, 245-258.






Course Requirements:

1. October 1, October 22, November 12: 3-5 page paper.
2. December 10: Term paper: 10 page paper.
3. Class attendance (Three unexcused absences will result in no evaluation)
4. Class assignments
5. Ethical scholarship
6. Ground rules




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Richard A. Aronson, MD, MPH
Adjunct Assistant Professor of Public Health
Richard A. Aronson, adjunct assistant professor of public health, received his B.A. from Amherst College, his M.D. from the University of Rochester School of Medicine, and his M.P.H. from the University of North Carolina School of Public Health in Maternal and Child Health (MCH). He has a wide range of leadership experience and community involvement in public health at the local, state, and national levels. He has served as the State MCH Medical Director in Vermont, Wisconsin, and Maine.

As a pediatrician, teacher, mentor, and maternal and child health leader, he seeks to put into practice the highest ideals of public health, public service, and medicine. His work focuses on social justice as the foundation for public health and on research and action to end health disparities and inequalities locally and globally.
His leadership has contributed to public policy that frames public health within an ecologic context that is rooted in family and community empowerment, resilience, social connections, cultural and linguistic competence, physical and emotional safety, and human rights. His focus on racial and ethnic disparities in infant mortality, child abuse prevention, and the impact of childhood experiences on adult health has helped unite multiple diverse stakeholders to discover common ground and improve health outcomes. He has concentrated his recent work on teaching, mentoring, and inspiring students who are interested and excited about public health as a uniquely inter-disciplinary field of study and community engagement. In 2009, he helped a group of Five-College students form a Public Health Collaborative at Amherst College.
His honors include the John C. MacQueen Lecture Award of the Association of MCH Programs (2004), the Ray Helfer MD Award from the Children’s Trust and Prevention Funds and American Academy of Pediatrics (2007), the Sydney S. Chipman Award of the University of North Carolina School of Public Health (1995), and the Wisconsin Outstanding Pediatrician of the Year (1999).

Culture and Language in Public Health Course

Following on the Health Disparities course at Hampshire College that Richard Aronson, MD, MPH, taught in the fall of 2009, he will offer a second course for the spring 2010 term that focuses on Culture and Language in Public Health. Here is the course description:

Cultural and linguistic competence in public health doesn’t mean being an authority on the values and beliefs of every culture. It does mean holding deep respect for cultural and language diversity; developing awareness of the ways in which culture and language shape our views of health and healing; and learning how every encounter in public health and health care is cross-cultural in nature. We explore how personal, organizational, and systemic bias contributes to health disparities; and how such understanding provides opportunities for humanizing health policy and creating health equity. The course examines cultural and linguistic conflicts that arise in efforts to improve the health of people and communities, and assesses the extent to which specific programs and policies make a lasting impact on health equity.

Health Disparities Course Hampshire College Fall 2009

By Richard A. Aronson, MD, MPH: For a long time now, I have been wanting to focus my full energy on teaching, mentoring, and being in dialogue with college level students to inspire them to pursue public health as a noble profession…a profession that: 1. Forms its foundation in the quest for social justice. 2. Honors the dignity of all people and communities throughout the world, and their languages and cultures and religions. 3. Unites multiple stakeholders for collaborative action. 4. Combines mind, body, and spirit in its vision of health. 5. Integrates and applies the internal and external dimensions of healing. 6. Focuses on common ground and celebrates diversity. 7. Represents an exquisitely inter-disciplinary field of study that combines the natural and social sciences, and humanities. 8. Fosters a legacy of hope. To that end, I am honored to have the opportunity to teach a course this fall at Hampshire College in Amherst, Massachusetts. The title of the course is “Health Disparities”, and it will be a seminar-type course for roughly 25 students, meeting twice a week (Tuesdays and Thursdays 2 – 3:20 pm Eastern Time USA). Students from the other colleges in the Five-College Area (Amherst, Smith, Mount Holyoke, and the University of Massachusetts) will be able to enroll. The course will be part of a Five-College Inter-Disciplinary Program called Culture, Health, and Science. I have put the course description below. I welcome suggestions for any reference materials (articles, books, videos, stories, poems, web sites, works of art, community organizations, etc.) that I could include in the syllabus or in the classes themselves or case examples of best practices. Thank you. I'm at raronson@myfairpoint.net. I look forward to hearing from you. Thank you!

Health Disparities Course Description
Fall 2009
Hampshire College Course 209 School of Natural Science
Room 333, Cole Science Center, 2-3:20 pm, Tuesdays and Thursdays
Professor: Richard A. Aronson, MD, MPH

Social injustice and inequality create conditions that lead to unconscionable health disparities according to race, ethnicity, gender, childhood experiences, and many other factors. An example is the infant mortality gap in the United States, where black babies die at more than twice the rate of whites. This course explores the origins of selected health disparities and highlights promising community-based efforts to address them. How do we define health disparities in a public health context? How do such disparities occur and persist across generations? What is the "life course perspective" for maternal and child health? Specifically, how does chronic stress experienced by women of color in the U.S. make them more likely to give birth to premature and low weight babies? And how are traumatic childhood experiences associated with earlier and more severe chronic diseases in adulthood? We will explore research related to these questions, and then consider specific promising community-based practices. We will critically examine how such practices: 1) Draw on the resilience of individuals, families, and communities; 2) Tap into the potential for social capital to enrich physical, mental, and spiritual health; 3) Foster collaborative action among multiple stakeholders, including the communities directly affected, to trust each other and unite as equal partners; and 4) Emphasize learning how culture and language influence health, and how the need to respect culture and to communicate clearly is essential to effective and humane programs, policies, and systems. Throughout the course, we will seek, in various ways, to include the voices of people and communities who have experienced disparities into our dialogue.

Amherst Public Health Collaborative May 2009

By Richard Aronson

As the academic year winds down, it's time to celebrate the creation of the Amherst College Public Health Collaborative and to honor the graduating seniors who have played a leadership role in its founding and initial events: Jodie Simms, Annah Kuriakose, Romain Cames, Surya Kundu, and Katerina Byanova. Also, many thanks to the Amherst Career Center, the Center for Community Engagement, the Five-College Culture, Health, and Science Program, the University of Massachusetts Amherst Public Health Club, Tapestry Health, Holyoke Health Center, Teen Clinic at Wm. J. Dean Technical High School, Big Brothers Big Sisters Hampshire County, Providence Prenatal and Women's Health Center in Holyoke, and many others. We are delighted that Jamie Cohen '11, Keemi Ereme '11, Lili Ferguson '10, Ethan Balgley '12, and Sarah Schear '12 have already taken on a leadership role for the transition to next year.

Here is the Mission Statement of the Collaborative:
The Amherst College Public Health Collaborative (ACPHC) brings together college students, faculty, staff, alumni, community partners and health care providers in order to engage in and promote issues of public health and social justice in the Pioneer Valley. ACPHC seeks to create long-term partnerships between community organizations and students, create a resource network for students interested in the field and highlight the importance of public health in the wider community. By including all relevant stakeholders, ACPHC aims to positively affect the health of the people living in the Pioneer valley, as well as to deepen the relationships between college students and local community by meaningfully engaging students in community health projects and by providing a means for students to apply classroom knowledge to the world they live in.

Culture and Language Workshops for Maine WIC

Richard Aronson and Lisa Sockabasin, Minority Health Director for Maine, will present two all-day workshops in June and September for staff of the Women, Infants, and Children Supplemental Nutrition Program (WIC). This is part of a three-year federal grant from the United States Department of Agriculture (USDA) to strengthen the capacity of WIC to deliver humane services and policies that demonstrate cultural and linguistic competence and show respect and honor for the dignity of all WIC children and families. We view this as an exciting new step to infusing research on racial and ethnic MCH disparities (James Collins, Michael Lu, others) into our workshops on cultural and linguistic competence. It will also incorporate the work that Aronson and Alyssa Pagano have done this year on the discourse of public health. Here is an overview of the workshops:

Understanding the Impact of Culture, Language, and Discrimination on WIC in Maine and Equipping WIC Providers with Tools to Improve Services to Families

June 12 (Augusta) and 30 (Bangor), September 21 (Augusta) and 30 (Bangor), 2009

Purpose: To strengthen the capacity of Maine WIC Agencies to provide leadership that honors and respects culture and language in: 1) Direct services to families; 2) The organization as a whole; and 3) The improvement of health outcomes and reduction of health inequalities in the WIC population.
Learning Objectives and Agenda:
Day One
1. Increase participant understanding of personal and organizational bias and prejudice, and how it may affect the relationship between the WIC agency and the community, and between WIC providers and the families who receive WIC services.
2. Increase understanding of how to address such bias and prejudice in order to better understand and respect each other and the families who receive WIC services.
3. Define culture and language.
4. Increase understanding of how culture and language affect the provider-family relationship and the extent to which a WIC agency is able to improve the health of the WIC population it serves.
5. Increase knowledge of how severe traumatic events and chronic stress affect birth outcomes and contribute to maternal and child health disparities.
Day Two
1. Increase knowledge of how laws and public policy, including the National Standards on Culturally and Linguistically Appropriate Services, can help WIC agencies strengthen their culture and language related services to families.
2. Identify essential elements to increase cultural and language respect in the WIC provider-family relationship, and develop a preliminary plan to put those elements into action.
3. Learn why organizational self-assessment is important, identify essential components of such an assessment, and develop a preliminary plan to carry out such an assessment.
4. Explore how to integrate all of the above into the skill sets and leadership of Maine WIC Agencies and the goal of improving the health of the WIC population, including all aspects of its policies, procedures, administration and VENA implementation plans.
Facilitators and Presenters: Richard Aronson and Lisa Sockabasin
Method: The sessions will consist of a combination of presentations, and small and large group activities and dialogue, using Future Search principles.

A Better Chance and Mentoring Workshops at Amherst

Please note the two upcoming workshops at the Amherst College Reunion on May 29 and 30, 2009:

Amherst College Alumni Reunion 2009 Saturday, May 30, 2009, 2:30 - 3:20 p-m

The Class of 1969 Project: A New Role for Alumni to Promote "Lives of Consequence"

This project, started in 2006 by Justin Grimes '69, organizes opportunities for Amherst alumni to inspire and equip students and young alumni with tools to make a difference in the world. "Through their hard work, Class of 1969 alumni, in partnership with students, faculty, CCE, Career Center, other graduates, and community partners have brought a number of fantastic programs to campus - including a program of inter-faith, inter-generational dialogue and an inspired colloquium that resulted in the formation of a student-led public health collaborative," wrote an '08 graduate. Working with established departments at the College, the project is opening doors for alumni to "give" to the College through involvement with students. An innovative program in Group Dialogue and Individual Mentoring for students interested in public health and service have also contributed to this redefinition of the alumni role in student life. Facilitated by Richard Aronson '69, we will hear the story of the project though the voices of undergraduates and young alumni. Presented by the Class of 1969.
Pruyne Lecture Hall (Room 115), Fayerweather Panelists: Jodie Simms, Joshua Stanton, Molly Mead, Christopher Dole

Friday, May 29, 2009 2 pm
Celebration of the Amherst ABC Program on its 40th Anniversary, and on the role of the Class of 1969, other alumni, and the College as a Whole in this Extraordinary Program
Facilitator: Richard A. Aronson ’69
Participants: A panel of Amherst College Class of 1969 alumni, Amherst College alumni who were students in the Amherst ABC (A Better Chance) Program (http://www.amherstabetterchance.org/), and Amherst ABC Board Members and others involved in the program throughout its history. Includes Michael Hawkins (Amherst ABC Board President), Frank Anderson (Invited - Initial Amherst ABC Board President),Jay Silverman ’69, Fred Hoxie ‘69, Henry Francis '71 (Invited)

The Amherst ABC Program was founded 40 years ago. In its senior year, the Class of 1969 decided to contribute to the founding of Amherst ABC by choosing to divert its yearbook-dedicated funds to ABC. The Class of 1969 is the only class in modern Amherst history without a year book. This workshop will explore: 1) The events leading to the Class of 1969’s decision, the summer of 1969 ABC orientation on the Amherst Campus, and reflections 40 years later. 2) The need for programs such as Amherst ABC 40 years ago, compared with today. 3) Opportunities for Amherst College and its alumni and students to make transformative changes in the community (in this case focusing on racial inequity and educational opportunity for low income youth of color) in Amherst and beyond. 4) The fundamental importance of philanthropy and non-profits in American society, and grassroots organizing, in the context of Amherst ABC as an example. The dialogue will be followed by a reception at the ABC House.

Amherst, AIDS, Activism: Launch Event Public Health Collaborative

By Jodie Simms, Amherst '09

Hello Members of the Amherst College Public Health Collaborative, including all who want to join!

This is to let you all know about the official launch event for the Amherst College Public Health Collaborative, which will be happening this Friday, April 10th, 2009, at 7:30 in the Cole Assembly Room, Converse Hall, at Amherst College. The title of the event is AIDS, Amherst, and Activism. The event is a way to excite students about the importance of public health, inform them about the developments in the AIDS field, and establish the collaborative as a resource on campus for students interested in public health. After a brief introduction of the Collaborative, we will be hearing from leading infectious disease specialists, Dr. Bruce Walker and Dr. Bisola Ojikutu, about their work addressing the global AIDS epidemic in South Africa with special regard to grassroots health care initiatives and community involvement and activism. Following the talk, there will be a discussion led by Dr. Walker, Dr. Ojikutu, and members of the Collaborative about public health in the community context and more specifically about how the Collaborative can be an effective grassroots initiative. Thanks to Jamie Cohen '11 for organizing this!

Somalian Community Health in Lewiston, Maine

Working with an extraordinary community organization in Lewiston, Maine, United Somali Women of Maine, in coordination with Lisa Sockabasin at the Maine state public health department and Rachel Salloway , a senior at Bates College, we are honored to be part of a community-based project to improve the health of the Somalian community in Maine. While the project focuses on immunizations, it has a broader context of listening to and learning from the voices and stories of Somalian women in Lewiston. In open dialogue, they are sharing their health experiences in Maine, including their own perceptions of illness, the extent to which they are honored and respected in their health care, and suggestions for systems wide improvement.

The Future of Home Births in the United States

On March 21-22, 2009, we co-faciitated with Future Search Network Co-Director Sandra Janoff a planning meeting for a Future Search Conference on the future of home births in the United States. Fifteen people, representing physicians, nurses, midwives, and mothers, gathered at the University of California at San Francisco Obstetrics-Gynecology Department for the start of a dialogue to constructively listen to each other's perspectives and discover common ground on this issue. Leslie Cragin, Director of Midwifery at UCSF and Saraswathi Vedam, Amherst College graduate and 2008 Honorary Degree recipient, took the lead in bringing this diverse group together.

Cultural Competence Workshops

We continue to design and offer innovative approaches to the learning and experience of cultural and linguistic competence. With Lisa Sockabasin, we will give four in-depth highly interactive workshops to the WIC (Women, Infants, and Children) Program in Maine; and we are in the midst of a series of workshops with an extraordinary group of Maine youth leaders with disabilities, in collaboration with Maine Support Network and co-facilitation by Mallory Cyr.

The Language of Public Health

We are working this semester with Alyssa Pagano, an English Major at Bates College, to write the first of a series of papers on the need to change the language of public health so that it is less bureaucratic jargon, has fewer acronyms, uses fewer violence related metaphors, and generally is more humane and inclusive of multiple and diverse stakeholders. Our goal is to humanize the language of public health so that it more accurately reflects and expresses the fundamental purpose and underlying ideals of our noble profession.

Amherst Public Health Collaborative Update

A group of Amherst and University of Massachusetts students gathered on February 23, 2009, to follow up on the January 24 all-day event that marked the foundation of the Amherst Public Health Collaborative. Since then, students have created a mission statement (see below), a blog site (http://aphcollaborative.blogspot.com/), a launch event on April 10 7:30-9:00 pm ("AIDS, Amherst, and Activism" with guest speaker Dr. Bruce Walker, at Converse Hall at Amherst College. Further, there is a great interest in expanding the already flourishing mentoring program. I want to express my gratitude to all who have taken the initiative to be part of this exciting model for college students to translate their knowledge and ideals into leadership and action.

Mission Statement

"The Amherst College Public Health Collaborative (ACPHC) brings together college students, faculty, staff, alumni, community partners and health care providers in order to engage in and promote issues of public health and social justice in the Pioneer Valley. ACPHC seeks to create long-term partnerships between community organizations and students, create a resource network for students interested in the field and highlight the importance of public health in the wider community. By including all relevant stakeholders, ACPHC aims to positively affect the health of the people living in the Pioneer valley, as well as to deepen the relationships between college students and local community by meaningfully engaging students in community health projects and by providing a means for students to apply classroom knowledge to the world they live in."

Public Health Collaborative Meeting at Amherst College

On Saturday, January 24, 2009, we had an amazing and powerful all-day gathering at Amherst College (Amherst, Massachusetts, USA) of 50 people that included Amherst College (and several University of Massachusetts) students, faculty and staff, alums, and community partners. Using the model of Future Search (www.futuresearch.org), we had an inspired dynamic action-oriented conversation and dialogue about public health that resulted in the formation of a new public health collaborative at Amherst that, while having its own unique identity, will at the same time join with a currently existing undergraduate group at the University of Massachusetts. The purpose of the collaborative is to establish a long-term presence of public health on the Amherst campus. It will have community engagement and partnerships (existing and new) at its core, promote opportunities in a variety of settings for students to learn about and practice public health and the reduction of health disparities (including those opportunities that already exist compiled in a data base), serve as a catalyst for student activism and leadership for campus-based and community wide public health issues, and provide multiple opportunities for in-depth mentoring for those who want to pursue public health after college. The underlying philosophy is that public health is, in an inter-disciplinary way, a legitimate academic subject for study at the undergraduate level, and that public health is a noble and highly diverse profession that is rooted in the pursuit of social justice, equity, peace, cultural respect, and healing as the foundation for creating conditions for people and communities and society to have the full equal opportunity to thrive in mind, body, and spirit. I am so excited about this!
A planning group of six people that included three students – Jodie Simms ‘09, Annah Kuriakose ‘09, Lili Ferguson ‘10-, one faculty (Prof. Chris Dole), and a facilitator, Alice Leibowitz) did a stellar job in clarifying the purpose of the day, reaching out to multiple stakeholders, and applying the Future Search model. Thanks also go to Documenter Danielle Griffin ’09 and our sponsors: Center for Community Engagement, Career Center, Dean of the Faculty, Dean of Student Affairs, Class of 1969 Project, and Humane Worlds Center for Maternal and Child Health. By all accounts, the gathering was unique and innovative and refreshingly inter-generational, building on the resources and strengths that already exist on the Amherst and University of Massachusetts campuses (we had hoped to involve all Five College in the area, but that will happen later). For many students, it gave them a much stronger sense of what public health is all about and a commitment to become involved in the new collaborative. For alums, it provided a new vehicle for them to become engaged in campus life and inspire students to believe more fully in their idealism and passion for public service. For community partners, it demonstrated that we were serious in involving them from the start as truly equal partners whose participation in a mutually beneficial way is absolutely essential to the success of this effort. More information about the event itself will be forthcoming.

Dick Aronson '69

Humane Worlds Center Student Opportunities 2009

Humane Worlds Center in Action January 2009

We are pleased to announce that we offer an array of exciting opportunities for students at all levels (undergraduate, graduate, and post-graduate) to become involved in the Humane Worlds Center! At the end of each section, see “Student Role”. Get in touch with us (207 215 7317 or raronson@verizon.net) if you'd like to join : as an elective, internship, independent study, or other way.


ENDING RACIAL AND ETHNIC INEQUALITIES IN INFANT MORTALITY WITH A FOCUS ON ADDRESSING RACISM

There is a large and unconscionable disparity in the rate at which African American and white babies die in the United States. In Wisconsin, black babies are four times more likely to die during their first year of life. To help address this, the University of Wisconsin School of Medicine and Public Health hired the Center’s founder and director, Richard Aronson, M.D., M.P.H., to review the research and promising practices on birth outcome disparities, and make recommendations for a special initiative by the University. Read his report at http://wphf.med.wisc.edu/specialinitiative/index.php and a presentation that he gave at a Wingspread Conference held in May 2008, at http://wphf.med.wisc.edu/specialinitiative/wingspread.php.

Student Role: Join future efforts to create equity in birth outcomes across racial, ethnic, economic, social, and other boundaries.

INSPIRING UNIQUE INTERGENERATIONAL DIALOGUE ON PUBLIC HEALTH

Extraordinary intergenerational dialogue between young and old public health leaders took place at a unique Maternal and Child Health Leadership Retreat in July 2008 organized by the MCH Program at the University of Illinois Chicago School of Public Health. (http://www.uic.edu/sph/mch/mch_leadership_conference.htm). A workshop given by Dr. Aronson and Sheri Johnson, “Practical Skills for MCH Leaders to Create Humane and Equitable Worlds”, and his presentation at the concluding session, “MCH Leadership Stories”, were instrumental in inspiring the dialogue.

Student Role: Be part of exciting future efforts to foster such dialogue in a variety of settings.

MENTORING AT AMHERST AND BEYOND!

Mentoring college students interested in public health is central to the purpose of the Humane Worlds Center. Such mentoring provides the seeds for a lifetime of leadership and service to make the world more just, a necessary prerequisite for people to be healthy.

The Amherst College Class of 1969 Project, started in 2006 by Justin Grimes (https://www.amherst.edu/alumni/classpages/1969/1969clpr) , has the purpose of inspiring students at Amherst and beyond to put their ideals into practice in careers of public service and leadership. As part of the Class of 1969 Project, Dr. Aronson organized a public service panel and mentoring that took place on March 28 and 29, 2008, at the Amherst College Career Center. Four Class of 1969 alumni, including Dr. Aronson, took part. Dr. Aronson mentored, in individual sessions following the panel, a dozen Amherst students interested in public health careers, and has continued contact with them. This was a successful and inspiring event. Below are words from some the students who took part in Dr. Aronson’s mentoring sessions:

“I am extremely grateful for all the advice and help that you gave me, both in terms of deciding what I wanted to do with my future, and also in terms of putting me in contact with people who could help me along the way. My final semester at Amherst I had so many ideas about what I was interested in and how I might want to make a difference, but I needed help in moving forward and focusing my dreams into something concrete. I believe that speaking with you helped me solidify my goals, and bring me to where I am right now. Based on our own discussions, and all the resources that you were able to offer me, I was inspired to contribute what little I could as well. I have been in contact with the Career Center and the Center for Community Engagement (about informing current Amherst students interested in public health about the organization that I'm working with, and the internship opportunities that we provide … Our mentoring session made a real difference in my life…”
“Looking back, I'm confident that the Amherst healthcare panel and meeting with you will be one of the most important events in my undergraduate life- if only because I finally learned that people have, and therefore CAN accomplish the goals we set for our communities when enough caring and open-minded people sit down together and try to work with one another.”
“Thank you so much for all your help, it has opened up so many new avenues for me.”
Jodie Simms and Annah Kuriakose, Amherst College Class of 2009, worked with Dr. Aronson in the fall of 2008 to organize an expanded panel, dialogue, and mentoring on public health as a career, that took place on December 5, 2008, at Amherst’s Career Center. Thirty five students turned out to join a dynamic conversation with five alumni and one faculty member.
Student Role: Be part of organizing similar efforts at Amherst and expanding it to other colleges in the United States and throughout the world.

PROMOTING RESILIENCE AND STRENGTHS IN THE FACE OF ADVERSE CHILDHOOD EXPERIENCES


Richard Aronson has given a number of presentations with Burt Richardson MD on the ACE (Adverse Childhood Experiences) Study, a powerful study that links traumatic childhood experiences – including various forms of abuse and neglect, domestic violence, mental illness, substance abuse in the household, incarcerated parent, and parental separation or loss – with adult health, metal and physical. The presentation also synthesizes the research of Emmy Werner and others on resilience, which offers a framework for preventing such traumatic experiences and promoting healing from them. Click here for slides.

Student Role: Help to prepare and give similar presentations, and lay the foundation for translating this research into action at the community and policy levels.


PLANNING A FUTURE SEARCH CONFERENCE ON HOME BIRTHS IN THE UNITED STATES

Humane Worlds Center is providing consultation to help organize and facilitate a Future Search Conference (www.futuresearch.net) on home births in the United States. It will be a multi-disciplinary consensus conference of key stakeholders around the provision of home birth services in the United States, to be convened by the University of California San Francisco and various organizations, including the American College of Obstetrics and Gynecology the American Academy of Pediatrics, the Association of Certified Nurse Midwives, Mothers and Midwives Associated, Lamaze International, Association of Women Hospital Obstetric and Neonatal Nurses, and the International Center for Traditional Childbirth. Further, it is hoped that public health practitioners and students, insurers, government agencies, health economists, medical anthropologists, state and national legislators, and women who have given birth will be among the eventual participants. The purpose of the conference is to start to bridge the "divide" between the medical and midwife communities over out-of-hospital births in the United States. Safety of birth in any setting is of utmost priority. Rights to choice and self-determination and culturally appropriate healing are also core values in American discourse that influence this issue. The purpose of this multidisciplinary conference of key stakeholders will be to craft a consensus policy and strategy on provision of home birth services. The project may also inform regulatory discourse, alternative funding structures, and the required modifications of curricula to prepare physicians and midwives in urban, rural and remote settings to provide maternity services across birth settings.
Student Role: Help to organize this conference and other Future Search Conferences, including possible conferences on MCH in South Africa and on maternal addiction in Maine.

A CONFERENCE TO INSPIRE UNDERGRADUATE STUDENTS TO BRING PUBLIC HEALTH TO THEIR CAMPUS

Humane Worlds Center, including Jodie Simms, Annah Kuriakose, and Elizabeth Ferguson – has combined with the Amherst College Career Center, Center for Community Engagement, Class of 1969 Project, and Dean of the Faculty to hold an exciting event at Amherst on January 24, 2009:
Public Health and Amherst College:
Establishing a Public Health Collaborative Group on Campus that Has Community Partnerships as its Foundation
The goal is to establish an ongoing student-led public health presence on campus that has local community partnerships as its foundation. To that end, the January 24meeting will be devoted to an exploration of: What is public health? What are the key public health issues at Amherst College? How can Amherst students strengthen their capacity to work in true partnership with communities? What does it mean to work in a spirit of collaboration with families and communities? The January 24, 2009, meeting will focus on strategies, both at Amherst and beyond, needed to equip students with the capacity to:

1) Change how we think about public health to embrace every facet of our lives;
2) Create forums for dialogue that lead to effective action on local and global health inequities; and
3) Humanize and dignify the services and policies that relate to public health.

The web link on the Amherst web site is:

https://www.amherst.edu/campuslife/interterm/courses#Public%20Health

The planning for the January 24 event reflects a commitment to bring together a diverse group of stakeholders from Amherst, surrounding communities, and public health in a spirit of collaboration and respect for each other’s voice and unique contribution. We will use Future Search principles to guide our meeting.

Future Search (www.futuresearch.net) is a unique planning method, which has been used with notable success in many of the world’s cultures, and which I have had the privilege and opportunity to practice for the past 15 years in the world of public health. This approach unites people from diverse walks of life, gives them a voice in shaping humane systems, and lays the foundation for action to create healthy communities. What differentiates Future Search from most strategic planning methods are its four principles, synthesized by Weisbord and Janoff from 75 years of social science research:
 Get the “whole system” in the room—those with authority, resources, expertise, information, and need—all in the same conversation.
 Explore the whole before seeking to fix any part. Each person has a part of the whole. When all stakeholders have the chance to put in what they know, each has a picture that none had coming in, and they can plan together in a shared context.
 Put common ground and future action front and center. Problems and conflicts become information to be shared, not action items.
 Set up meetings so people can do the work for themselves. With self-management and personal responsibility encouraged, groups are capable of doing much more than they are usually asked to do.

To learn more about this event or to register for it, contact Jodie Simms, jsimms09@amherst.edu, or Annah Kuriakose, akuriakose09@amherst.edu

Student Role: Be involved in the follow-up to this conference and help organize other such conferences throughout the world.


PREVENTING CHILD ABUSE

Humane Worlds Center presented the keynote address at a Statewide Child Abuse Retreat for Oklahoma on November 5, 2008. The event was sponsored by the Oklahoma State Department of Health, Family Support and Prevention Service, and the Oklahoma State Interagency Child Abuse Prevention Task Force. Dr. Aronson focused his talk on how society has a vested interest in seeing that all children do well, that they thrive in mind, body, and spirit; and that we all benefit when children grow up to become healthy, productive, and compassionate adults. The interests of society as a whole – indeed, its very security – depend on the health and safety of our children. They ride on the extent to which we invest in children as our most precious resource and in parenthood and childrearing as the most important of all “occupations”. Dr. Aronson cited Jacqueline Kennedy Onassis, who said, “If you bungle raising your children, nothing else in life matters very much.” In September 2008, Dr. Aronson wrote a grant on the prevention of shaken baby syndrome in Maine.

Student Role: Be part of future efforts to prevent child abuse and neglect through workshops, grants, articles, and joining state, local, national, and international coalitions

MATERNAL AND CHILD HEALTH COMMUNITY LEADERSHIP IN THE CARIBBEAN THROUGH THE AMERICAN PUBLIC HEALTH ASSOCIATION

On the weekend of October 25-26, 2008, Dr. Aronson once again participated, as core faculty, in the Maternal and Child Health Community Leadership Institute of the American Public Health Association. The Institute took place at the APHA Annual Meeting in San Diego, California, and this year focused on MCH issues and challenges in the Caribbean. A team of 10 public health practitioners and students from Trinidad, Jamaica, Barbados, and Guyana took part in a fascinating dialogue on leadership related to the public health issues unique to these countries. After reviewing the key areas of research that have important implications for mobilizing the power of communities, I presented the Future Search principles and engaged the group in an exercise rooted in these principles.

The purpose of the Maternal and Child Health Community Leadership Institute is to assist MCH program coordinators, program managers, and MCH advocates in developing and honing their leadership skills to effectively address the health concerns of women and children. The Institute, started in 2000, helps build capacity within each team (participants) in order to strengthen the MCH infrastructure within their community. This course provides a forum for the exploration of new paradigms, and new ways of approaching some of the complex and long-lasting issues related to improving maternal and child health for all populations. Overall the Institute is a part of APHA's continuing efforts to address one of its key priority areas--eliminating racial/ethnic health disparities. Despite efforts in MCH, research still shows that the healthcare needs of women and children are not being met. In order to address these issues of inadequate care, faculty members employ an interdisciplinary approach that addresses a community's "social and human capital," to assist leaders, citizens, and communities become active participants by diffusing and applying acquired social and scientific knowledge and integrate this new information into evidence-based public health practice. MCH leadership and its key attributes will be defined and methods to apply these skills will be reviewed as well as real time application (framed by the MCH Leadership Competencies). The necessary skills both from theory and practice, such as their ability to promote the health and well being of women and children or their genuine commitment, are assessed. How to be an effective MCH leader is discussed and participants are shown ways to hone or improve their skills. "MCH Leadership competencies: Working with communities and systems" are incorporated in order to promote community engagement, and this is the part that I served as faculty for. This is includes developing the relationships and dialogue between community members and those in leadership roles. This collaborative process should promote exchange of information, ideas, and resources. This course will provide participants with the knowledge to adequately define “what is a community” and demonstrate the necessary skills needed to engage the community. Participants are not only exposed to best practices but also given the opportunity to learn practical skills and develop an action plan to implement once they have returned to their communities. Ultimately, through their collaborative work, these teams will create sustainable and replicable efforts that improve the quality of life for mothers and children in communities worldwide.

Student Role: Be part of future work with the MCH Community Leadership Institute and other leadership development seminars and curricula development.

LEADERSHIP DEVELOPMENT FOR YOUTH WITH SPECIAL HEALTH NEEDS AND DISABILITY WITH A FOCUS ON ADDRESSING PREJUDICE AND BIAS
Dr. Aronson is partnering with Lisa Sockabasin, Minority Health Director for the State of Maine CDC (Public Health Agency) to hold a series of leadership dialogues for youth with special health needs and/or disability. Here is information about the first in the series , held in December 2008 (http://www.servicesforme.org/ ) :

Leadership and Communication: Taking a Closer Look
Leadership Development Series for Youth Ages 14-22 with Special Health Needs and/or a Disability, December 13, 2008, 9:30 a.m.- 2:00 p.m., Senator Inn, 284 Western Avenue, Augusta, Maine

This day included a leadership learning session and an informational meeting for youth with special health needs and/or a disability who might be interested in joining a regional or state Youth Advisory Council in Maine, USA.

In the Leadership session, we held a conversation about the differences between people. Sometimes we use differences as a way to divide ourselves from each other, or to act in ways that hurt others. By understanding how this kind of behavior works, we can become better at treating others in the same way that we expect to be treated. Through a video and conversation, we started to understand prejudice: not as something that only some people have, but as something that we all may show in communicating with others. By understanding how we all have a tendency to be prejudiced, we can learn how to listen to each other with respect and treat each other in ways that are fair. Some of us have experienced prejudice merely because of our health issues or disability. This series of workshops is an opportunity to learn how to stay positive in all our communications, and to:
• Understand how each of us is unique in how we view our world, and how that makes a difference in how we listen and communicate with each other?
• Understand the meaning of culture and how it applies to you?
• Get involved in a leadership role in Maine?
Presenters: Richard Allan Aronson, MD, MPH, Humane Worlds Center. Dick lives in Hallowell, Maine. He is grateful for the amazing opportunities for education and inspiration for public service that he has had throughout his life. Dick is deeply committed to peace, social justice, and equality for all people. He is especially dedicated to making the world better and more humane for children and youth. He has aspired to put his ideals into action through his leadership as a healer (pediatrician) and public servant (public health needs). He really enjoys teaching that engages everyone in interactive dialogue, and conversation in which all voices are deeply respected. Joining Dick is Lisa Sockabasin, Director of Minority Health for the Maine CDC (Public Health Agency).

Co-sponsors: The Maine Support Network on behalf of Maine Department of Health and Human Services, Maine CDC, Children with Special Health Needs (CSHN). This workshop is designed for youth ages 14-22 with Special Health Needs and/or Disability.

Student Role: Help develop future sessions in this series and future dynamic conversations with other groups.

PROMOTING CULTURAL AND LINGUISTIC COMPETENCE AS A KEY STRATEGY TO END HEALTH DISPARITIES AND CREATE EQUITY

For more than 15 years, Dr. Aronson’s leadership has focused on promoting the practice of cultural and linguistic competence in a wide variety of public health, maternal and child health, and human services organizations, and in communities. He is a Senior Consultant to the National Center for Cultural Competence at Georgetown University, and has given numerous keynotes, workshops, and consultations throughout the United States. A current project involves a three-year U.S. Department of Agriculture Grant to the Women, Infants, and Children (WIC) Supplemental Nutrition program for the State of Maine. Humane Worlds Center , in partnership with the Minority Health Office at the Maine CDC (Public Health Agency), is providing a unique educational program to WIC Program Staff that seeks to integrate the practice of cultural and linguistic practice into all aspects of WIC services and operation. This educational program represents a synthesis of several bodies of research that are at the heart of the Humane Worlds Center.

Student Role: Be part of the development of this educational program and its application.

PROMOTING CULTURAL AND LINGUISTIC COMPETENCE AS A KEY STRATEGY TO END HEALTH DISPARITIES AND CREATE EQUITY


War and social injustice related to war have a profound impact on the health of mothers and children. Since 2001, hundreds of thousands of American parents have served in Iraq and Afghanistan. They are part of a U.S. military that has a greater percentage of mothers and fathers than it has had in any other war. Of roughly 263,000 people currently deployed overseas, about 43 percent are parents. Children with a parent at war are vulnerable to anxiety, depression, and other effects, some of which may last throughout their lives and pass to future generations. Homecomings are traumatic as well, especially when parents return with physical or emotional wounds.

There is an urgent need for public health and maternal and child health to place this issue front and center on our agenda. Humane World Center is deeply committed to this effort. Following the 2008 John MacQueen Lecture by Dr. Victor Sidel and a subsequent workshop that we organized at the Association of MCH (AMCHP) Programs Annual Meeting, we formed a peace and social justice maternal and child health work group. This group meets on a regular basis to establish a movement in maternal and child health to create a culture of peace and non-violence. We will give another workshop on February 22, 2009, at the AMCHP Annual Meeting. We view war as part of the continuum of violence prevention that is integral to MCH. We seek partnerships with military parents, National Guard, and other military agencies that provide MCH services to affected families, including mental health. If we cooperate in new ways, we
can make a difference in families, communities, and at the national level. Our long-term goal, consistent with public health s essence, is the primary prevention of war. This means the creation of a culture of peace in society at all levels. In our workshop, through a panel and interactive format, we 1) report on the work of our group to date; 2) highlight an educational initiative to raise urgency for action by the MCH community; 3) bring family voices and military MCH providers into our dialogue; and 4) propose incorporating this issue into the Five-Year State MCH Strengths and Needs Assessment in 2010.

Learning Objectives for the February 22, 2009, Workshop:
By the end of this presentation, attendees will better understand 1) the impact of war on the MCH population; and 2) the urgency to make this issue an MCH priority. Further, attendees will learn about the work group s actions to date and plan a course of action for the following year.

Student Role: Be part of the creation of this movement, including coordination of the group, and preparation and presentation of workshop and other materials.

Humane Worlds Center January 2009

Purpose: To inspire a new generation of leaders in public health and service to create conditions under which all children and youth have the full equal opportunity to thrive in body, mind, and spirit. Background: Those of us invested in public health face local and global challenges in dealing with maternal and child mortality, violence in all forms including child abuse, obesity and other forms of malnutrition, mental illness, asthma, and many other complex issues. Our objective is to create a world more humane and equitable for women and children. To make progress, we need broad participation of many stakeholders, which requires new forms of leadership. The Humane Worlds Center for Maternal and Child Health intends to provide that leadership. The Center draws on new research that shows 1) How various forms of inequality, injustice, and stress influence health, 2) How resilience and other positive resources provide the potential to create health equity, and 3) How leadership rooted in fostering inclusive dialogue and collaborative action form the foundation for the new leadership. We provide consultation on the translation of this research into humane practice. We provide an array of educational experiential opportunities to those who seek to learn and practice such leadership. We mentor those who have a passion for public health and seek tools to translate their idealism into action. Our method of choice for this work is Future Search, a unique planning process that has been used with success worldwide for 25 years to stimulate unprecedented action.

By this means we seek to unite stakeholders and serve as a catalyst for essential but previously unlikely partnerships. Our intention is to enable people to discover common ground for action that they did not realize they shared. Such discovery can lay the foundation for leadership needed to bring dignity, hope, and equity to women and children. We seek to move away from systems that thrive on pathology, medical diagnosis, and risk reduction. Instead, we envision systems that derive their power from resilience, trust, and community. Our species has a remarkable capacity for healing and cooperating for the common good. The purpose of the Center is to mobilize that capacity. To support this service mission, we sponsor research on effective methods and mentor those who intend to practice new forms of social action. In so doing, we equip a new generation of leaders with lifelong tools to actualize their ideals.

Public Health: Our purpose in public health, defined by the USA Institute of Medicine and World Health Organization, is to foster conditions that assure optimal health in mind, body, and spirit. We commit to ending health inequities and protecting human dignity. In MCH, we seek to change social conditions so that children experience humane worlds. Such worlds help meet basic needs and support their safety and well being.

Vision: Our vision is to bring the highest ideals of public health into the lives of children and families everywhere and to improve their health by:
1) Humanizing the worlds that they experience;
2) Changing how we think about public health to embrace every facet of their lives;
3) Creating forums for dialogue that lead to effective action on global health inequities; and
4) Educating and inspiring a new generation of public service leaders to carry on this work in the long term.

Goals: We seek to 1) Create equity and end MCH disparities by radical strengthening of the capacity of all concerned parties for participatory leadership. 2) Involve young people in all aspects of our operation, so as to educate and inspire new leadership in public health. 3) Set foundations for societal changes to make equity and justice in MCH a reality; and 4) Challenge individual and organizational biases; 5) Respect all voices, including those historically marginalized; and 6) Promote opportunities for shared learning.

Expertise: We specialize in:

1. Synthesizing several bodies of research that will have a significant impact on maternal and child health practice over the next 50 years. 2. Translating this research into humane MCH and public health practice and leadership. 3. Integrating cultural and linguistic competence into public health and health as key strategy to end health disparities. 4. Changing the language of public health and medicine to better reflect our ideals and purpose. 5. Bringing multiple stakeholders together to untangle complex public health challenges and take collaborative action to solve them. 6. Inspiring a new generation of leaders in public health and service.

Services:

1. Consultation to individuals, communities, organizations to build capacity in the above, by A) Giving keynotes, motivational speeches, presentations, workshops. B) Organizing forums with intergenerational and cross-cultural dialogue. C) Writing papers and grants. 2. Teaching, mentoring, and leadership, through A) Individual and group mentoring. B) Internships to build leadership capacity of young people. 3. Organization and facilitation of interactive meetings with broad stakeholder participation to unite diverse parties and spark action to create public health equity.


For more information, contact:
raronson@verizon.net
207 215 7317 Cell
207 622 8822 Office
www.humaneworldscenter.blogspot.com
www.humaneworldscenter.org